TY  - THES
A1  - Schmitz, Detlef
T1  - Ausstattung und Kompetenz zur notfallmedizinischen Versorgung bei niedergelassenen Ärzten
T1  - Equipment and competenz for emergency medical aid ad doctors in own practice
N2  - Bei 155 Ärzten und Arzthelferinnen wurde ein Notfalltraining durchgeführt. Davor und danach wurde ein multiple-choice-Test mit acht Fragen zur Reanimation durchgeführt. Es zeigte sich ein signifikanter Anstieg der richtigen Antworten von 69,7 % auf 94,7%. Teilnehmer, deren letztes Training bis zu zwei Jahre zurücklag, erreichten signifikant bessere Ergebnisse. Ebenso wurde durch Fragebögen die Ausstattung von 118 Arztpraxen untersucht. Hier zeigten sich erhebliche Unterschiede je nach Fachrichtung des Arztes. Nur ca. 20 % der Ärzte sind mit modernen AED-Geräten zur Defibrillation ausgestattet. Gerätschaften zur Intubation halten ca. 90 % vor, Sauerstoff dagegen nur ca. 80%, Sauerstoff-Reservoire weniger als die Hälfte. Opiate sind nur bei 72% bevorratet, Cordarex nur bei einem Drittel. Folgende Forderung lassen sich ableiten: -verpflichtende Fortbildungsmaßnahmen zur Reanimation -dies mindestens alle zwei Jahre (im Rahmen des Qualitätsmanagements) -Verbesserung der notfallmedizinischen Geräte- und Medikamentenausstattung
N2  - A training in emergency medical aid was realized with 155 doctors and physician assistants. They were tested before and afterwards with a multiple-choice-test with eight questions. A significant increase of correct answers from 69,7% to 94,4% was shown. Participants, who had a training in a period of the last two years, get significant better results. Also the equipment of 118 medical practices was tested by questionaries. Significant differences depending on specializations was shown. Only about 20% are equipped with modern AED´s for defibrillation. Equipment for intubation has about 90%, oxygen only about 80%, oxygen-reservoirs less than the half. Only 72% are equipped with opiods, only a third with cordarex. Because of this following postulations: -obligatory training in reanimation and resuscitation -at least all two years ( within quality management) -improvement of medical and technical equipment
KW  - Reanimation
KW  - Ausstattung
KW  - Notfallmedizin
KW  - niedergelassener Arzt
KW  - Beatmung
KW  - resuscitation
KW  - equipment
KW  - emergency medical aid
KW  - defibrillation
KW  - doctor in own practice
Y1  - 2006
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-22667
ER  - 
TY  - JOUR
A1  - Gilbert, Fabian
A1  - Klein, Detlef
A1  - Weng, Andreas Max
A1  - Köstler, Herbert
A1  - Schmitz, Benedikt
A1  - Schmalzl, Jonas
A1  - Böhm, Dirk
T1  - Supraspinatus muscle elasticity measured with real time shear wave ultrasound elastography correlates with MRI spectroscopic measured amount of fatty degeneration
JF  - BMC Muscoskeletal Disorders
N2  - Background:
Fatty Degeneration (FD) of the rotator cuff muscles influences functional and anatomical outcome after rotator cuff repair. The MRI based estimation of fatty degeneration is the gold standard. There is some evidence that Ultrasound elastography (EUS) can detect local differences of tissue stiffness in muscles and tendons. Shear-wave elastography (SWE) was evaluated to determine the extent to which shear wave velocity was associated with measures of fatty degeneration. MRI-spectroscopic fat measurement was used as a reference to quantify the amount of fat in the muscle belly.

Methods:
Forty-two patients underwent SWE of the supraspinatus muscles at its thickest diameter. After ultrasound evaluation an MRI-spectroscopic fat measurement of the supraspinatus muscle was performed using the SPLASH-technique. A gel filled capsule was used to locate the measured area in the MRI. The values of shear wave velocity (SWV) measured with SWE and spectroscopic fat measurement were correlated statistically using Pearson’s correlation test.

Results:
Correlation of the fat amount measured with MRI-spectroscopy and the SWV measured with SWE was ρ =0.82. Spectroscopic measured fat ratio of the supraspinatus muscle ranged from 0% to 77.41% and SWV from 1.59 m/s to 5.32 m/s. In 4 patients no sufficient SWE could be performed, these individuals showed a larger diameter of the overlying soft tissue. SWV measured with SWE showed a good correlation with MRI spectroscopic fat amount of the supraspinatus muscle.

Conclusion:
These preliminary data suggest that SWE may be a sufficient tool in detecting and estimating the amount of fatty degeneration in the supraspinatus muscle in real time. Large overlying soft tissue may be a limitation in performing sufficient EUS.
KW  - shoulder surgery
KW  - rotator cuff
KW  - MRI
KW  - ultrasound
KW  - fatty degeneration
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-159378
VL  - 18
IS  - 549
ER  -